Comparison of the Medical Burden of COVID-19 with Seasonal Influenza and Measles Outbreaks in Children in Bnei Brak

Background : Measles, influenza and COVID-19 outbreaks affected Bnei-Brak city during 2018-2020. We examined the medical burden of each of these outbreaks.

Methods: We retrospectively analyzed data of all COVID-19, measles and influenza pediatric patients hospitalized in Mayanei HaYeshuah during 2018-2020. Data included demographics and clinical course. We compared hospitalization rates and complications associated with each of these infections.

Hospitalization rate of each agent was determined by dividing the number of Bnei-Brak residing children, hospitalized at Mayanei HaYeshuah, by the known or estimated number of infected children in Bnei-Brak. The denominator for measles was obtained from the Ministry of health. The denominators for influenza and COVID-19 were estimated as 15% and 12% of the pediatric population in Bnei-Brak, respectively.

We also performed a sensitivity analysis with estimation that 30% and 10% of children in Bnei-Brak were infected with influenza and COVID-19, respectively.

Results: During the study period, a total of 247, 33 and 32 children were hospitalized with influenza, COVID-19 and measles respectively. Complication rates were higher following measles and influenza, compared to COVID-19. Hospitalization rates for measles, influenza and COVID-19 were 10%, 1.15% and 0.22%, respectively. Relative risks (RR) with 95% confidence intervals (CI) for hospitalization following measles and influenza compared to COVID-19 were 46 (27-72) and 5.3 (3.5–8.1), respectively. Sensitivity analysis also revealed higher hospitalization rates following influenza than following COVID-19 (RR: 2.18 [1.5-3.3]).

Conclusions: Hospitalization rates and direct medical burdens of measles and influenza were significantly higher than that of COVID-19 infection in children.